Correlates and Predictors of Criminal Legal Involvement in People With First-Episode Psychosis

Objective: Because limited research has evaluated criminal legal involvement (CLI) during a first episode of psychosis (FEP), we explored rates, correlates, and predictors of CLI among people with FEP.

Methods: We conducted a secondary analysis on the Recovery After an Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) study, a cluster randomized controlled trial conducted from 2010 to 2012 with people experiencing FEP in the US. We explored rates of recent CLI prior to baseline and over the 2-year follow-up and evaluated predictors of CLI at baseline and over the follow-up period (N = 381).

Results: At baseline, 11% of the sample reported CLI within the past month, which was significantly associated with lower education, longer duration of untreated psychosis, lifetime alcohol or any drug use disorder (other than cannabis), and more severe excitement factor symptoms on the Positive and Negative Syndrome Scale (PANSS). Over the 2-year follow-up, 13.6% of the sample reported CLI which, controlling for baseline CLI, was predicted by longer duration of untreated psychosis, schizophrenia diagnosis, lifetime alcohol or any other drug use disorder, alcohol or cannabis use in the 30 days prior to baseline, and more severe positive and excitement symptoms on the PANSS at baseline. Those with CLI at baseline were nearly 3 times more likely to have subsequent CLI over the follow-up. Baseline CLI was associated with dropping out of treatment due to incarceration.

Conclusion: The findings suggest that CLI in people with FEP could be reduced by earlier detection and more effective treatment of psychotic symptoms, substance use, and criminogenic risk factors.

Trial Registration: Data used in this secondary analysis are from ClinicalTrials.gov identifier: NCT01321177.